Wiki R10.13 and R14.0 denied.

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tthyq5

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Hi everyone,
We got denial from insurance for office visit, Dx codes are R10.13. R14.0 and R15.2. Insurance denied saying "PAYMENT IS NOT ALLOWED FOR THIS SERVICE BECAUSE THE DIAGNOSIS CODES BILLED ARE NOT APPROPRIATE WHEN BILLED TOGETHER.” But I can't see any notes in ICD 10 books, not sure this is something new. Please help!
Thank you so much in advance!
 
Hello TThyq5
I believe understanding the payer s comments& denial. Dx code R15.2 is Fecal Urgency why not use Diarrhea dx K59.1? The dx R10.13 is Epigastric Pain dyspepsia why not use dx K30 Dyspepsia? And Dx R14.0 Bloating is symptom of those 2 other dx codes or could use K21.9 Reflux if all documented. Selecting definitive dx are better than symptoms codes,but depends on provider s selection of dx codes& documentation and treatment provided. They may feel it is integral coding or not more specific in selecting definitive dx code. But if the provider selected this as coder you can only show him or her the denials due from their picking all R codes .
Well hope this makes sense to you
Lady T
 
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